Organization
CRYSTAL LAKE CHIROPRACTIC, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANINE FELICE-JOHNSON D.C. (PRESIDENT)
(231) 882-5533
Entity
Organization
Contact information
Practice address
6635 NORTH ST, BENZONIA, MI 49616-9765
(231) 882-5533
(231) 882-1361
Mailing address
6635 NORTH ST, BENZONIA, MI 49616-9765
(231) 882-5533
(231) 882-1361
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301007090
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950A010070
BCBS
MI
Enumeration date
08/26/2011
Last updated
09/28/2011
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